Pelvic actinomycosis associated with bilateral hydronephrosis developed in a nulligravida woman / 대한산부인과학회지

Pelvic actinomycosis is well-known to be associated with the longstanding use of intrauterine devices, sometimes related with a pregnancy history and an obstetric and/or gynecologic surgery. It can extend to the retroperitoneum and may also be associated with ureteral obstruction. In this case, pelvic actinomycosis in the form of bilateral tubo-ovarian abscess extending to the retroperitoneum resulting in bilateral hydronephrosis occurred in a nulligravida woman who had only few prior sexual intercourses. Apparently, pelvic actinomycosis can occur without any specific history. Moreover, such could possibly give rise to hydronephrosis by direct extension to the retroperitoneum.

Chylous ascites, following radical hysterectomy with pelvic lymph node dissection in a patient with cervical cancer / 대한산부인과학회지

Chylous ascites is a disorder caused by various diseases and conditions that interfere with the abdominal or retroperitoneal lymphatics. There are several gynecologic reports on chylous ascites with radiation therapy and para-aortic lymph node dissection. However, the report of chylous ascites caused by performing only pelvic lymph node dissection was extremely rare. In most cases after surgical trauma, it is resolved after dietary managements but it may be associated with serious nutritional and immunologic consequences due to the constant loss of protein and lymphocytes. The authors experienced a 42-year-old woman with cervical cancer Ib1 who presented with chylous ascites after a radical hysterectomy and bilateral pelvic lymph node dissection. She was successfully managed by fasting and low fat diet. We report this case of chylous ascites following pelvic lymph node dissection with a brief review of literature.

Expression of Survivin in extrapelvic endometriosis / 대한산부인과학회지

OBJECTIVE: To examine survivin expression in extrapelvic endometriosis. METHODS: The study group consisted of 14 cases with extrapelvic endometriosis which were confirmed histologically. The control group (total, n=47) was divided into 2 groups. Group I included normal endometrium (n=34) obtained from hysterectomy specimens with myoma and without endometriosis. Group II included ovarian endometrioma (n=13) obtained from laparoscopy. Expression of survivin was immunohistochemically confirmed. RESULTS: In extrapelvic endometriosis, the expression of nucleus in glandular epithelium and stromal cells were significantly stronger than normal endometrium. But cytoplasm expression of glandular epithelial cells and stromal cells in extrapelvic endometriosis showed statistically lower in comparison with normal endometrium. In ovarian endometrioma, the expression of nucleus in glandular epithelial cells and stromal cells was significantly stronger than normal endometrium. But the expression of nucleus in glandular epithelial cells with ovarian endometrioma was stronger than during proliferative phase but was not significant. Also cytoplasm expression of ovarian endometrioma was lower than normal endometrium. There was no difference in survivin expression between extrapelvic endometriosis and ovarian endometrioma. CONCLUSIONS: In extrapelvic endometriosis, survivin expression was stronger than normal endometrium except cytoplasm. Our findings suggest that increased survivin expression may contribute to survival of extrapelvic implants.

LEEP conization: Risk factors of positive margin / 대한산부인과학회지

OBJECTIVE: Conization is the popular procedure to diagnose or treat in most cases of cervical intraepithelial neoplasia (CIN) and some cases of early cervical cancer. Many reports show the conservative management of positive margin is reasonable. Nevertheless, it is generally accepted the positive margin of conization is the major cause of being received additional operation such as hysterectomy. The aim of this study is to evaluate the risk factors of positive margin. PATIENTS AND METHODS: 283 CIN or early cervical cancer women who underwent conization were enrolled this study. We evaluated many possible risk factors for positive margin, including age, weight, height, body mass index (BMI), gravity, parity, abortion, severity of disease, glandular involvement, and human papillomavirus (HPV) infection. RESULTS: Of the 283 patients, 80 (28.2%) had positive margin in their conization specimens. Statistical significant risk factors of positive margin included older age (P(trend) < 0.001), higher BMI (P(trend) = 0.036), more severity of disease (P(trend) < 0.001), and involvement of endocervical gland (OR = 2.5, 95% CI 1.5-4.2). Parity (P(trend) = 0.054) showed statistically marginal significance. Weight (P(trend) = 0.154), height (P(trend) = 0.456), gravity (P(trend) = 0.194), abortion (P(trend) = 0.813), and HPV infection (OR = 1.2, 95% CI 0.5-2.5) were not statistically significant risk factors. CONCLUSIONS: The data of present study demonstrated that older age, high BMI, and higher pathologic diagnosis are statistical risk factors of positive margin we can know preoperatively.

A case of solitary fibrous tumor arising from the vagina / 부인종양

Solitary fibrous tumor (SFT) arising from the vagina is a very rare benign stromal tumor, which has a well-demarcated margin and proliferation of spindle cells with the absence of any atypical features. Immunohistochemically, the cells are strongly positive for CD34. Surgical resection of the tumor is recommended as a definite treatment. Clinical courses of SFT are almost benign but long-term follow-up of SFT of the vagina have not been reported yet. We have experienced a case of solitary fibrous tumor arising from the vagina and report this case with a brief of literature.

Ovarian Pregnancy: Two Cases Report / 대한산부인과학회지

Ovarian pregnancy is an uncommon variant of ectopic pregnancy. Spiegelberg's criteria should be fulfilled for the diagnosis of ovarian pregnancy. The reported incidence is 0.5-3% of all ectopic pregnancies. The reported frequency of ovarian pregnancies remained stable. It seems that the frequency is underestimated because some of the suspected tubal pregnancies treated conservatively with methotrexate, without laparoscopic validation, are in fact early ovarian pregnancy. The improvements in ultrasonography, methods for hCG detection, and operative laparoscopy have led to earlier and more accurate diagnosis of ovarian pregnancies. The therapy of ovarian pregnancy is surgical in the first place, and medical treatment with systemic or local methotrexate injection can be applicable after confirming diagnosis of ovarian pregnancy by laparoscopy, in women in a stable condition. Two cases of histologically proven primary ovarian pregnancy are presented with brief review of literature.

Survivin and Bcl-2 expression in eutopic endometrium with and without endometriosis / 대한산부인과학회지

OBJECTIVE: To examine expression of survivin and Bcl-2 in eutopic endometrium with endometriosis and without endometriosis by immunohistochemical stain. METHODS: Expression of survivin and Bcl-2 was immunohistochemically investigated in eutopic endometrium with endometriosis (n=30, study group I; laparoscopy-proved endometriosis, study group II; adenomyosis) or without endometriosis (n=34, control group). The score of immunohistochemical staining was evaluated semi-quantitative method modified by Sinicrope and Lu. Statistical analyses was carried out using one-way ANOVA with Turkey test. RESULTS: Survivin expression was significantly higher in nucleus of glandular epithelium of eutopic endometrium with endomtriosis compared to that without endometriosis (p<0.05). Increased expression of Bcl-2 was found in glandular epithelium of eutopic endometrium with endometriosis than without endometriosis, but there was no significantly difference. CONCLUSION: Our findings suggest that increased survivin expression may contribute to survival of endometriosis. Moreover, survivin could play an important role in pathogenesis of endometriosis.

4 Cases of pelvic actinomycosis associated with intrauterine contraceptive device / 대한산부인과학회지

Pelvic actinomycosis is a rare chronic anaerobic infectious disease, which occurs most commonly in association with an IUD. It is difficult to diagnose the disease initially. In most cases, the diagnosis is made postoperatively because of its diverse clinical manifestations and courses. Besides it is frequently misdiagnosed as pelvic malignancy or endometriosis. If physician has a full understand to these characteristics of pelvic actinomycosis, the use of preoperative antibiotics can reduce the risk of pelvic structure injuries and then a patient can be saved from an extensive surgical procedure. We experienced four cases of pelvic actinomycosis complicated by tubo-ovarian abscess in women wearing IUD and report it with a brief review. In three cases, it was helpful that preoperative intravenous antibiotics therapy.

A case of mixed type large cell neuroendocrine carcinoma of the uterine cervix / 대한산부인과학회잡지

Neuroendocrine carcinomas of the uterine cervix are very rare cervical neoplasms. It has frequent distant metastasis at diagnosis and high recurrent rate against multimodality therapies such as surgery, chemotherapy and radiation therapy. In 1997, four categories of endocrine tumors of uterine cervix were recommended by the Cancer Committee of the College of American Pathologists and the National Cancer Institute. It has been suggested that infection of human papillomavirus and molecular biologic abnormalities in genomic level are causes of this disease. Although a lot of studies about this disease concerning therapies and prognostic factors have been reported, there is no standard therapeutic regimens because of low incidence and difficulties of histologic diagnosis, so further studies about this issues are required. We report a case of large cell neuroendocrine uterine cervical carcinoma treated with chemotherapy followed by surgery.

A Clinical Study on the Recent Tendency of Pregnancy and Delivery in Women Aged 35 Years and Older / 대한산부인과학회잡지

OBJECTIVE: To access the pregnancy tendency and delivery in women aged 35 years and older. METHODS: From December 1999 to May 2001, 954 deliveries were in Ilsan Paik Hospital. Among them we compared 89 cases of pregnant women aged 35 years and older with under 30 year of age as control group 99 cases. The statistical analysis was performed using Chi-square tests, Mantel-Haenszel trend test, and statistical significance was defined as p value<0.05. RESULTS: The preterm delivery was higher in women aged 35 years and older (study group) (31.5%) than control group (8.1%) and cesarean birth (C/SEC) rate also higher in study group (61.8%) than control group (36.3%). In antenatal complications, there are no differences in both groups, but in postpartum complications, 4 cases hysterectomy were in study group compared with control group 1 case. In comparison of neonatal outcomes, neonatal intensive care unit (NICU) admission and congenital anomalies are higher in study group. Especially, in comparison of nulliparous women, study group (n=21) have higher C/SEC rate and preterm delivery than control group (n=63), but in pregnancy outcome there was no differences in both groups. CONCLUSION: There are no significant differences in pregnancy outcomes in both group, although preterm delivery and C/SEC rate are higher in elderly gravida. So elderly gravida is no more than high risk group, if appropriate management will be done.

Preterm delivery between 34-36weeks of gestation; Is it danger? / 대한산부인과학회잡지

OBJECTIVE: We performed this study to determine the safety and danger of preterm delivery at gestational age 34-36 weeks through antenatal profiles, neonatal conditions, neonatal morbidities. METHODS: We reviewed our antenatal and neonatal data between December 1999 and April 2001 to determine the morbidities of infants delivered at gestational age 34-36 weeks using x2test and Fisher's exact test. RESULTS: 1. Mean age was 30.8+/-4.58yrs and mean gravida was 2.68+/-1.56. Preterm premature rupture of membrane was higher in preterm delivery at gestational age 34 and 35weeks(respectively 58.6%, 50%). There was no difference in using tocolytics but, antenatal steroid treatment for prevention of respiratory distress syndrome(RDS) was most frequent in gestational age 34weeks.(20.68%). 2. There was no difference in the risk factor of preterm labor at each group. 3. 1-minute Apgar score<7 was significantly more frequent in neonates at gestational age 34weeks but neonatal weight and meconium staining were not different. 4. The rate of neonatal intensive care unit(NICU) admission was significantly higher in neonates delivered at gestational age 34weeks(93.1%), and RDS occurred in 3 cases delivered at gestational age 34weeks(10.34%). 2 cases delivered at gestational age 34 weeks needed the use of ventilator. CONCLUSION: Our study shows significant differences in neonatal morbidities between 34weeks and the others. In particular, all cases of Respiratory distress syndrome(n=3) occur in neonates delivered at 34weeks gestation not receiving antenatal steroid treatment and neonatal morbidities at 35 and 36weeks of gestation were not different with full term gestation.

Pregnancy Outcome of Natural and In-vitro Fertilization Twin Pregnancy / 대한주산의학회잡지

No abstract available.

Prenatal ultrasonic detection of endocardial cushion defect in 1 case / 대한산부인과학회잡지

No abstract available.

A case of advanced abdominal pregnancy / 대한산부인과학회잡지

No abstract available.